Do Tantalum and Titanium Cups Show Similar Results in Revision Hip Arthroplasty?

Abstract

Porous surfaces are intended to enhance osteointegration of cementless implants. Tantalum has been introduced in an effort to enhance osseointegration potential of uncemented components. We therefore compared the clinical outcome of acetabular components with two different porous surfaces. We retrospectively reviewed 283 patients (295 hips) who underwent cementless revision hip arthroplasty with either an HA-coated titanium cup (207 patients, 214 hips) or porous tantalum cup (79 patients, 81 hips). The minimum followup was 24 months in both groups (titanium: average 51.8 months, range, 24-98 months; tantalum: average, 35.4 months, range, 24-63 months). The titanium and tantalum groups had a mechanical failure rate (clinical plus radiographic) of 8% and 6%, respectively. In hips with minor bone deficiency (type 1, 2A, 2B using the classification of Paprosky et al.), 6% of titanium cups and 4% of tantalum cups failed. In hips with major bone deficiency (type 2C, 3), 24% of titanium cups and 12% of tantalum cups developed failure. In the major bone deficiency group, the tantalum cups had fewer numbers of lucent zones around the cup. Eighty-two percent of titanium cups that failed did so at 6 months postoperatively or later, whereas 80% of tantalum cups that failed did so in less than 6 months. Radiographically in the major group, tantalum cups yielded better fixation.

Acetabular revision arthroplasty using trabecular titanium implants

“…These tantalum implants are clearly beneficial compared to previously used roof reinforcement rings and cages in the presence of a large acetabular defect [24,25].…”

Treatment of Severe Bone Defects During Revision Total Knee Arthroplasty with Structural Allografts and Porous Metal Cones—A Systematic Review

“…The highly porous characteristics of these new porous metal compounds are claimed to further increase rapid and early osteointegration [22,34] and should therefore diminish the loosening rate and improve clinical results and long term outcomes. If failures occur, they tend to happen early on in the postoperative period according to Jafari et al [35]; in their group of 79 patients who had undergone total hip revision surgery with TM augments, 4 out of 5 failures occurred in the first 6 months postoperatively. However, the advantages of these porous implants are negated if they are cemented to viable bone.…”

Systematic review on outcomes of acetabular revisions with highly-porous metals

“…The newer metals have high porosity and greater surface frictional properties which potentially can improve the initial fixation strength of the cup-bone interface and enhance osseointegration and durable long-term fixation. Jafari et al in a retrospective analysis of 295 hips at approximately twoto four-year follow-up reported that hips with major acetabular bone loss had lower aseptic failure rates with tantalum cups (12 %; three out of 26 hips) in comparison to conventional porous-coated cups (24 %; five out of 21 hips) [48]. The aseptic failure rate in the minor bone loss group using tantalum was 6 % (five out of 81) in comparison to 8 % (17 out of 214 hips) with conventional implants.…”